Molecular Analysis of Group A Streptococcal Isolates Associated with Scarlet Fever in Southern Taiwan between 1993 and 2002

Yan, Jing Jou; Liu, Ching Chuan; Ko, Wen Chien; Hsu, Shui Yuan; Wu, Hsiu Mei; Lin, Yee Shin; Lin, Ming Tsan; Chuang, Woei Jer; Wu, Jiunn Jong

doi:10.1128/jcm.41.10.4858-4861.2003

Cited by 23 publications

(20 citation statements)

References 27 publications

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“…Those investigators suggested that host factors, including individual and population-based immunity, must also be significant in influencing the infection potential. Among the M serotypes, M1, M2, M3, M4, M6, and M22 were detected among the isolates associated with scarlet fever (11,24,25,34). In this study, we showed that the prevalent emm types for the S. pyogenes isolates collected in central Taiwan between 1996 and 1999 were emm4 (45%), emm12 (36%), emm1 (8%), and emm22 (7%).…”

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confidence: 75%

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Epidemiology and Molecular Characterization ofStreptococcus pyogenesRecovered from Scarlet Fever Patients in Central Taiwan from 1996 to 1999

et al. 2004

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One hundred seventy-nine Streptococcus pyogenes isolates recovered from scarlet fever patients from 1996 to 1999 in central Taiwan were characterized by emm, Vir, and pulsed-field gel electrophoresis (PFGE) typing methods. The protocols for Vir and PFGE typing were standardized. A database of the DNA fingerprints for the isolates was established. Nine emm or emm-like genes, 19 Vir patterns, and 26 SmaI PFGE patterns were detected among the isolates. Among the three typing methods, PFGE was the most discriminatory. However, it could not completely replace Vir typing because some isolates with identical PFGE patterns could be further differentiated into several Vir patterns. The prevalent emm types were emm4 (n ‫؍‬ 81 isolates [45%]), emm12 (n ‫؍‬ 64 [36%]), emm1 (n ‫؍‬ 14 [8%]), and emm22 (n ‫؍‬ 13 [7%]). Some emm type isolates could be further differentiated into several emm-Vir-PFGE genotypes; however, only one genotype in each emm group was usually predominant. DNA from nine isolates was resistant to SmaI digestion. Further PFGE analysis with SgrAI showed that the SmaI digestion-resistant strains could be derived from indigenous strains by horizontal transfer of exogenous genetic material. The emergence of the new strains could have resulted in an increase in scarlet fever cases in central Taiwan since 2000. The emm sequences, Vir, and PFGE pattern database will serve as a basis for information for the long-term evolutionary study of local S. pyogenes strains.Streptococcus pyogenes causes a variety of human diseases ranging from relatively mild skin infections to severe invasive diseases, such as acute rheumatic fever, glomerulonephritis, puerperal sepsis, necrotizing fasciitis, meningitis, and streptococcal toxic shock syndrome (9,29). Among the diseases caused by this pathogen, scarlet fever, characterized by a strawberry tongue, skin rash, and sore throat, is most prevalent in schoolchildren aged 4 to 7 years. In Taiwan, scarlet fever is a notifiable disease, with 150 to 230 confirmed cases per year from 1996 to 1999. Since only 9% of the medical centers, regional hospitals, and district hospitals in central Taiwan had ever reported cases to the health authorities from 1996 to 1999, the number of scarlet fever cases should be severely underreported. Scarlet fever outbreaks are not uncommon at daycare centers, kindergartens, and elementary schools (5, 16). However, the molecular epidemiology of this disease has not been well studied in Taiwan.Analysis of the clonal relationships between clinical isolates from patients by various typing methods is a practical approach to elucidation of the epidemiology of a disease. To date, a number of phenotyping and genotyping methods have been described for S. pyogenes (1, 3, 10, 13, 18-20, 22, 26, 27, 30, 33). Among these methods, M serotyping has been taken as the "gold standard" for the characterization of S. pyogenes strains, in light of its importance to streptococcal virulence. However, application of M serotyping is restricted due to the lack of a comprehensive set...

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confidence: 75%

“…The epidemiologic pattern, however, is inconsistent with that in southern Taiwan, 180 km away. Yan et al (34) showed that only the emm1 (72.7%), emm4 (26.0%), and emm25 (1.3%) types were found among the isolates recovered in southern Taiwan from 1993 to 2002. The emm1 isolates appeared in all years studied.…”

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confidence: 99%

Epidemiology and Molecular Characterization ofStreptococcus pyogenesRecovered from Scarlet Fever Patients in Central Taiwan from 1996 to 1999

et al. 2004

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“…1,2 Though it is not as severe as it was before, scarlet fever outbreaks still occur in some schools, 3 and it remains a notifiable disease in such regions as Western Australia 4 and Taiwan. 5 This paper reports a special outbreak of scarlet fever with a rare route of transmission at Hongtang Secondary School.…”

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confidence: 98%

Report and analysis of a scarlet fever outbreak among adults through food-borne transmission in China

Yang

Dong

et al. 2007

Journal of Infection

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“…emm typing and PFGE typing. emm typing and PFGE typing were performed as previous described (46). The PFGE fragment patterns were interpreted in accordance with the criteria of Tenover et al (41).…”

Section: Methodsmentioning

confidence: 99%

emm1/Sequence Type 28 Strains of Group A Streptococci That ExpresscovRat Early Stationary Phase Are Associated with Increased Growth and Earlier SpeB Secretion

Chiang-Ni

Zheng²,

et al. 2009

J Clin Microbiol

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Streptococcus pyogenes (group A streptococcus [GAS]) is a versatile human pathogen, and emm1/sequence type 28 (ST28) is the most frequently isolated type from GAS infections. The emm1/ST28 strain is associated with necrotizing fasciitis and streptococcal toxic shock syndrome. Growth-phase regulation is one of the important regulatory mechanisms in GAS, which controls gene expression at restricted phases of growth. CovRS, a two-component regulatory system, is considered the regulator of streptococcal pyrogenic exotoxin B (SpeB) and is thought to be activated in the exponential phase of growth. In the present study, Northern hybridization analysis showed that 52% of the analyzed GAS strains expressed covR at the exponential phase, but 48% of the strains expressed covR at the early stationary phase of growth. Strains transcribing covR at the early stationary phase showed better growth and earlier SpeB expression than the other group of strains. Multilocus sequence typing and pulsed-field gel electrophoresis analysis showed only emm1/ST28 strains (which comprise a clonal cluster) were expressing covR at the early stationary phase of growth, indicating that emm1/ST28 strains have special characteristics which may be related to their worldwide distribution.

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Molecular Analysis of Group A Streptococcal Isolates Associated with Scarlet Fever in Southern Taiwan between 1993 and 2002

Cited by 23 publications

References 27 publications

Epidemiology and Molecular Characterization ofStreptococcus pyogenesRecovered from Scarlet Fever Patients in Central Taiwan from 1996 to 1999

Epidemiology and Molecular Characterization ofStreptococcus pyogenesRecovered from Scarlet Fever Patients in Central Taiwan from 1996 to 1999

Report and analysis of a scarlet fever outbreak among adults through food-borne transmission in China

emm1/Sequence Type 28 Strains of Group A Streptococci That ExpresscovRat Early Stationary Phase Are Associated with Increased Growth and Earlier SpeB Secretion

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